Hepatitis B and C Seroprevalence in Solid Tumors - Necessity for Screening During Chemotherapy

Background: Hepatitis B and C are the leading causes of liver diseases worldwide. For hematological and solidmalignancy patients undergoing chemotherapy, increases in HBV DNA and HCV RNA levels can be detectedwhich may result in reactivation and hepatitis-related morbidity and mortality. The aim of this study was todetermine the seroprevalence of Hbs ag and Anti HCV positivity in patients with solid malignancies undergoingchemotherapy and consequences during follow-up. Materials and
Methods: The files of 914 patients with solidmalignancies whose hepatitis markers were determined serologically at diagnosis were reviewed retrospectively.All underwent adjuvant/palliative chemotherapy. For the cases with HBV and/or HCV positivity, HBV DNAand HCV RNA levels, liver function tests at diagnosis and during follow-up and the treatment modalities thatwere chosen were determined.
Results: Of 914 cases, Hbs Ag, anti Hbs and anti HCV positivity were detectedin 40 (4.4%), 336 (36.8%) and 26 (2.8%) of the cases respectively. All of the Hbs ag positive patients receivedprophylactic lamuvidine before the start of chemotherapy. In the Hbs ag and anti HCV positive cases, liverfailure was not detected during chemotherapy and a delay in chemotherapy courses because of hepatitis wasnot encountered.
Conclusions: Just as with hematological malignancies, screening for HBV and HCV shouldalso be considered for patients with solid tumors undergoing chemotherapy. Prophylactic antiviral therapy forHBV reduces both the reactivation rates and HBV related mortality and morbidity. The clinical impact of HCVinfection on patients undergoing chemotherapy is still not well characterized.